REBEL Cast

REBEL Core Cast 131.0 – Traumatic Arthrotomy

Nov 13, 2024
Discover the serious implications of traumatic arthrotomy, where even small lacerations can expose joints to infection. Learn about essential diagnostic techniques, including the importance of CT scans in evaluating joint injuries. The discussion emphasizes the need for prompt orthopedic consultation and antibiotic administration to prevent complications. You'll also hear about the nuances of physical exams and how specific findings can indicate joint involvement. It's a deep dive into a critical area of emergency medicine that could save lives.
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ADVICE

Suspect Open Joint Near Lacerations

  • Always suspect an open joint if a laceration is near a joint, regardless of size.
  • Explore the wound locally with anesthesia, irrigation, and probing to assess depth and joint involvement.
ADVICE

Use CT Scan for Diagnosis

  • Start evaluation with X-rays to look for intra-articular air but expect low sensitivity.
  • Use CT scanning for better detection as it shows near 100% sensitivity for joint violation.
ADVICE

Saline Load Test Limitations

  • The saline load test can identify open joints by injecting saline and watching for leakage.
  • It’s uncomfortable, variable in sensitivity, and mostly replaced by CT in many settings.
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